Behaviour-change stewardship bundle nearly doubles appropriate-duration antibiotic prescribing in OPAT for urinary tract infection

A quasi-experimental study (n=314) tested a behaviour-change-informed antimicrobial stewardship bundle for patients receiving outpatient parenteral antimicrobial therapy (OPAT) for urinary tract infection Primary Study (Gómez-Zorrilla et al.1). The bundle raised appropriate-duration prescribing from 44.4% to 83.3%, and intravenous-to-oral switch from 62.8% to 85.7%; it cut 90-day UTI recurrence (odds ratio 0.41) and reduced costs (median −€649 per patient), without increasing readmissions.

The study design is quasi-experimental (before-and-after) rather than randomised, which limits causal certainty relative to a controlled trial, though the consistency of improvement across prescribing duration, IV-to-oral switch, recurrence and cost outcomes strengthens the finding. It describes a Spanish OPAT service; the specific stewardship bundle would need local validation before adoption elsewhere.

For OPAT services managing urinary tract infection as a high-volume indication, the bundle offers a directly transferable stewardship template, built around behaviour-change principles rather than a novel drug or device.